Just one Ebola patient treated at a U.S. hospital will generate eight 55-gallon barrels of medical waste every day.

Protective gloves, gowns, masks and booties are donned and doffed by all who approach the patient’s bedside and subsequently lost. Disposable medical tools, packaging, bed linens, cups, plates, tissues, towels, pillowcases and whatever which is utilized to clean up after the individual must be thrown away.

Even curtains, privacy beds and screens finally must be treated as contaminated medical waste and disposed of.

Dealing with this assortment of pathogen-filled debris without tripping new infections is an authorized and logistical challenge for each U.S. hospital currently preparing for a possible trip by the virus.

In California and other states, it’s an even worse waste-management nightmare.

While the U.S. Centers for Disease Control and Prevention recommends autoclaving (a kind of sterilizing) or incinerating the waste as a surefire way of destroying the germs, burning waste is effectively banned in California, also prohibited in several other states.

“Storage, transportation and disposal of this waste will be a significant issue,” California Hospital Association President C. Duane Dauner warned Sen. Barbara Boxer, D-Calif., in a letter a week.

Even some countries that generally allow incineration are throwing up barriers to Ebola waste.

In Missouri, the state attorney general has sought to bar Ebola-contaminated debris by a St. Louis incinerator run by Stericycle Inc., the country’s largest medical waste disposal company.

Due to restrictions on burning, California hospital agents say their only option seems to be trucking the waste over public highways and incinerating it in another country — a prospect which makes some environmental advocates uneasy.

Rules for transportation

Under national transportation guidelines, the substance would be designated a Class A infectious substance, or one that is capable of causing death or permanent disability, and might require special approval from the Department of Transportation, hospital agents state.

“We fully expect that it is coming our way,” Bayer said of this virus. “Not to create any sort of scare, but just handed the makeup of the population and the hub that we are. It’s very possible” It can’t survive a 1,500-degree scorching in a incinerator, or the prolonged, pressurized steam of an autoclave. “It’s killed by bleach, by autoclaving, by an assortment of chemicals.”

But, CDC guidelines note that”chemical inactivation” has yet to be standardized and could activate worker safety regulations.

Getting prepared

California health officials lately tried to reassure residents that the state’s private and public hospitals were up to the job and were actively training for the possible coming of Ebola.

“Ebola does not pose a significant public health risk to California communities at the current time,” explained Dr. Gil Chavez, an epidemiologist and deputy director at the California Department of Public Health. “Let me tell you why: Current scientific evidence specifies that individuals can’t access Ebola through the atmosphere, food or water. … The Ebola virus does not survive over a few hours on impervious surfaces”

It was uncertain if California officials saw the waste issue as a possible issue.

Although one third of the state’s private hospitals and”a few” of its public hospitals reported to Boxer’s office that there could be problems complying with the CDC’s incineration recommendation, along with many others, a state public health official told reporters he was not aware of any conflicts.

“Here’s what we’ve heard from the CDC: It’s OK,” Perrott explained. “But then we’ve heard from some sources, that perhaps we need to fix it somehow and then flush it down the toilet or you need to consult local authorities. It seems perhaps a bit gross, but there’s a real question about what to do with that waste.”

Dr. Thomas Ksiazek, a professor of microbiology and immunology at this University of Texas Medical Branch, has said he believes there has been a good deal of overreaction regarding Ebola medical waste.

“There are other methods to manage the waste; autoclaving would be chief among them,” Ksiazek mentioned. “The issue is, most physicians don’t use it for many disposable items. They are quite pleased to bag them up and send them into some normal medical disposal company.”

But Allen Hershkowitz, a senior scientist at the Natural Resources Defense Council, said incineration is straightforward and powerful, and must be available to hospitals to help dispose of this mountain of waste.

Hershkowitz said claims began to crack down on medical waste incineration years ago because substances which didn’t need to get burned were sent to combustors and so were emitting dangerous pollutants.

In this case of Ebola medical waste, he said California should reconsider its limitations.

“There is no pollutant that’s going to come out of a waste incinerator that’s more dangerous than the Ebola virus,” Hershkowitz said. “When you’re dealing with biological and sociological dangers, sometimes the safest thing to do would be combustion.”

by: http://www.sfgate.com/news/article/Another-challenge-disposing-of-waste-5909413.php

But Allen Hershkowitz, a senior scientist at the Natural Resources Defense Council, said incineration is simple and effective, and should be available to hospitals to help dispose of the mountain of waste.

Hershkowitz said states began to crack down on medical waste incineration years ago because materials that didn’t need to be burned were being sent to combustors and were emitting dangerous pollutants.

In this case of Ebola medical waste, he said California should reconsider its restrictions.

“There’s no pollutant that’s going to come out of a waste incinerator that’s more dangerous than the Ebola virus,” Hershkowitz said. “When you’re dealing with pathogenic and biological hazards, sometimes the safest thing to do is combustion.”

by: http://www.sfgate.com/news/article/Another-challenge-disposing-of-waste-5909413.php

The Board of County Commissioners struck plans Thursday to get a regional waste-to-energy incinerator, preferring to haul the county’s waste into a landfill with a short-term contract rather. Commissioners Paul Smith and Billy Shreve cast the dissenting votes to keep the project on the dining table while the county explores its options.

“It is absolutely no charge to the county to keep these options available,” Smith stated. “To do away with these options is mad.”

Terminating the project won’t cost the county any money as the Northeast Maryland Waste Disposal Authority, a quasi-governmental agency which helps the county fulfill its trash disposal needs, will pay the $500,000 conclusion fee. Any remaining funds after this payment is going to be divided between Frederick County and Carroll County, which was a partner in the project. These funds are out of obligations the authority has obtained from Wheelabrator after the service contract was executed in 2010.

However, Young said that he saw no purpose in voting to keep plans for an incinerator, which would burn garbage into energy, open because County Executive-elect Jan Gardner intended to scrap the facility after taking office Dec. 1. Young stated.

County Attorney John Mathias stated Gardner held the power to determine the fate of the incinerator project, not the County Council, when a decision was not made Thursday.

“I believe that you should terminate the entire thing,” Gardner testified in front of the plank and approximately 100 people gathered at Winchester Hall, garnering some applause.

The board unanimously voted in favor of transporting the county’s crap into a out-of-state landfill for $50.95 per ton with a highest last-minute contract.

After considering five suggestions, including three out-of-state prices and two waste-to-energy facilities outside Maryland, the commissioners narrowed their options between two landfills with varying contracts.

Commissioners formerly leaned toward the first option, which provided contracts stretching 25 years at an average of $54.97 per ton, though this cost might escalate annually with the consumer price index and gas rates. On the other hand, the board chose the second option, which Gardner also preferred.

About 30 people testified in front of the board concerning the incinerator project, with a bit more than half in favor of scrapping it and the rest advocating for maintaining the project on the desk to consider it more intensely.

“The incinerator is a waste of energy, a waste of resources (also ) a waste of cash,” Brunswick resident Ellis Burruss testified. “It would be good not to waste any more time .”

Other inhabitants noted that the proposed location of the incinerator, near Monocacy National Battlefield, would ruin the playground ’s tourism and beauty.

However, resident Greg Brown voiced his support for a regional incinerator, supposing it was more environmentally friendly than the other options commissioners were considering.

“Even the top landfills … are at least three times more pollutant than the usual waste-to-energy facility,” Brown stated.

Another resident stated Europe has been constructing waste-to-energy centers for years with no unwanted effects that many have brought up.

“I was actually with this (incinerator project), but with all the energy prices and Carroll County falling out … that I ’m not,” Delauter said, echoing the thoughts of Young and Gray.

Another resident said Europe has been building waste-to-energy facilities for years without the negative consequences that many have brought up.

Jim Warner, CEO of the Lancaster County Solid Waste Management Authority in Pennsylvania, pitched a proposal for hauling the county’s trash, but the commissioners decided to go with an undisclosed out-of-state landfill with a short contract.

“I was actually for this (incinerator project), but with the energy prices and Carroll County dropping out … I’m not,” Delauter said, echoing the sentiments of Young and Gray.

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